Risk factors for falls in Parkinson's disease and other parkinsonisms

Abstract

Background: Falls represent a prevalent yet often overlooked symptom in Parkinson's disease (PD) and other parkinsonisms believed to stem from a combination of motor, sensory, and cognitive impairments, in addition to environmental and social factors. Research question: This study aimed to assess the impact of clinical and sociodemographic variables on the risk of falls in individuals diagnosed with PD or other parkinsonisms. Furthermore, the investigation sought to identify potentially modifiable risk factors associated with falls within this patients group. Methods: The retrospective case-control study involved the analysis of an anonymized database comprising 735 patients with PD or different types of parkinsonism, including atypical parkinsonism, and other parkinsonism (drug-induced, vascular, parkinsonism of undetermined background). Results: Age (OR: 1.039, p < 0.001), dementia (OR: 1.862, p = 0.012), vitamin B12 deficiency (OR: 2.667, p = 0.005), polypharmacy (OR: 2.493, p < 0.001), walking with assistance (OR: 3.248, p < 0.001), and posture deformities (OR: 2.199, p < 0.001) all contributed to falls in the study group. Additionally, patients with progressive supranuclear palsy (OR: 5.532, p < 0.001) and multiple system atrophy (OR: 4.993, p = 0.003) were significantly more prone to falls, whereas patients with PD (OR: 0.245, p < 0.001) experienced falls less frequently. Significance: Factors such as low vitamin B12 concentration and polypharmacy are potentially modifiable and, therefore, may constitute viable targets for the prevention of falls in patients with PD and other parkinsonisms.

Keywords

• Parkinson's disease
• Atypical parkinsonism
• Risk factors for falls
• Postural deformities
• polypharmacy
• Vitamin B12